Family Therapy Drop-Outs: Resistance to Change

Abstract

This paper presents an analysis of resistance to change in family therapy — a concept central to the understanding of drop-outs. The resistances used were categorized as Resistance to Therapy, Resistance to Interaction and Family Specific Resistances. Family behaviour was conceptualized as governed by homeodynamic patterns, self-reinforcing modes of interaction in which the primary emphasis is on the preservation of stability. Five families who dropped out of therapy after up to 17 sessions were described in detail. They had consulted for psychiatric symptoms presented by one or more children, and were treated by the author in weekly conjoint family sessions. The dynamic interplay of resistance and change was apparent in all five cases where family members resisted working through the marital conflict, and disrupted treatment when imminent change in the husband-wife relationship was perceived as a threat to family stability. The discussion dealt with the crucial role of the parental couple's strengths and weaknesses as a prognostic indicator, the importance of re-assessing treatment goals after the family is fully engaged in therapy, and the role of the therapist in provoking drop-out. In addition, the drop-outs were compared to families who remained in therapy.

Quantitative evaluation of family functions and changes in a postmodern context

“…It is important to understand that the family naturally tries to avoid change, because within the family change is associated with crisis, pain, risks that the family cannot manage, because they are risks in fields in which the family has not developed skills [58].…”

Decision‐Making as to the Choice of Family Therapy in an Adolescent In‐Patient Setting

“…In addition to the obstacles to family therapy stemming from the family (17), the patient, and the therapist, one must also consider how much energy and how much time an institution leaves available to meet the requirements of especially difficult families. Under the best of circumstances the psychiatric resident is over‐burdened with work and an especially difficult family perhaps creates the situation of “the straw that breaks the camel's back.” Also, it is not impossible that some supervisors and team directors may have some resistance to CFT as a method of treatment and convey this to the resident in subtle ways.…”

Values and family therapy.

“…Quantitative reports by Sager et al (1968), Shapiro and Budman (1973). Solomon (1969), andSlipp et al (1974) highlight the need to find means to engage families of diverse origins.…”